Treatment in canine epilepsy – a systematic review

BMC Veterinary Research

Holger A Volk²  David Brodbelt¹  Marios Charalambous² 

[1] Department of Production and Population Health, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, Herts, UK;Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, Herts, UK

关键词: Canine;    Treatment;    Antiepileptic drugs;    Epilepsy;    Systematic review;   

Others  :  1114897
DOI  :  10.1186/s12917-014-0257-9

 received in 2014-09-06, accepted in 2014-10-15,  发布年份 2014

【 摘 要 】

Background

Various antiepileptic drugs (AEDs) are used for the management of canine idiopathic epilepsy (IE). Information on their clinical efficacy remains limited. A systematic review was designed to evaluate existing evidence for the effectiveness of AEDs for presumptive canine IE. Electronic searches of PubMed and CAB Direct were carried out without date or language restrictions. Conference proceedings were also searched. Peer-reviewed full-length studies describing objectively the efficacy of AEDs in dogs with IE were included. Studies were allocated in two groups, i.e. blinded randomized clinical trials (bRCTs), non-blinded randomized clinical trials (nbRCTs) and non-randomized clinical trials (NRCTs) (group A) and uncontrolled clinical trials (UCTs) and case series (group B). Individual studies were evaluated based on the quality of evidence (study design, study group sizes, subject enrolment quality and overall risk of bias) and the outcome measures reported (in particular the proportion of dogs with ≥50% reduction in seizure frequency).

Results

Twenty-six studies, including two conference proceedings, reporting clinical outcomes of AEDs used for management of IE were identified. Heterogeneity of study designs and outcome measures made meta-analysis inappropriate. Only four bRCTs were identified in group A and were considered to offer higher quality of evidence among the studies. A good level of evidence supported the efficacy of oral phenobarbital and imepitoin and fair level of evidence supported the efficacy of oral potassium bromide and levetiracetam. For the remaining AEDs, favorable results were reported regarding their efficacy, but there was insufficient evidence to support their use due to lack of bRCTs.

Conclusions

Oral phenobarbital and imepitoin in particular, as well as potassium bromide and levetiracetam are likely to be effective for the treatment of IE. However, variations in baseline characteristics of the dogs involved, significant differences between study designs and several potential sources of bias preclude definitive recommendations. There is a need for greater numbers of adequately sized bRCTs evaluating the efficacy of AEDs for IE.

【 授权许可】

   
2014 Charalambous et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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